title: The 2013 WHO guidelines for antiretroviral therapy: evidence-based recommendations to face new epidemic realities.
abstract: OBJECTIVE
  The review summarizes the key new recommendations of the WHO 2013 guidelines for antiretroviral therapy and describes the potential impact of these recommendations on the HIV epidemic.
  
  
  RESULTS
  The 2013 WHO guidelines recommend earlier initiation of antiretroviral therapy (ART) at CD4 500 cells/μl or less for all adults and children above 5 years. Further recommendations include initiation of ART irrespective of CD4 cell count or clinical stage for people co-infected with active tuberculosis disease or hepatitis B virus with severe liver disease, pregnant women, people in serodiscordant partnerships, and children under 5 years of age. The ART regimen comprising a once daily fixed-dose combination of tenofovir + lamivudine (or emtricitabine) + efavirenz is recommended as the preferred first-line therapy. Several approaches are also recommended to reach more people and increase health service capacity, including community and self-testing, and task shifting, decentralization, and integration of ART care.
  
  
  CONCLUSIONS
  If fully implemented, the 2013 WHO ART guidelines could avert at least an additional 3 million deaths and prevent close to an additional 3.5 million new infections between 2012 and 2025 in low- and middle-income countries, compared with previous treatment guidelines.
authors.affiliation: HIV Department, World Health Organization, Geneva, Switzerland.
authors.forename: Meg
authors.initials: M
authors.lastname: Doherty
authors.forename: Nathan
authors.initials: N
authors.lastname: Ford
authors.forename: Marco
authors.initials: M
authors.lastname: Vitoria
authors.forename: Gundo
authors.initials: G
authors.lastname: Weiler
authors.forename: Gottfried
authors.initials: G
authors.lastname: Hirnschall
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D017408:Guidelines as Topic; D006801:Humans; D014777:Virus Diseases / Q000188:drug therapy* / Q000453:epidemiology*; D014944:World Health Organization
chemical_list: D000998:Antiviral Agents